Losing Hair After 4 Years on TRT

I have been on TRT for 4 years now. I started TRT because I started to get symptoms out of no where. I don’t know what happened to my body. All of a sudden I could not achieve a Errection. I started to become less interested in sex and I was always fatigue. Long story short my testosterone came back to 308. So I ended up on TRT. I truly did not want to be on TRT but i could not think of any other options to get my life back. Now after 4 years I have been losing massive amounts of hair and it is very noticeable. If anyone could please help it will be greatly appreciated. I’m not really interested on taking more medications to counter the side effects of TRT but at the same time I need help I do not want to lose all my hair. Please help

My current dosage is testosterone cypionate 12mg daily and 300i.u. HCG Every other day.

Most recent labs

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You could lower your dose a bit (since you are a bit above range), but it’s probably not going to help very much.

You can try over the counter stuff like Rogain. The stuff works for most, but it’s something that you need to be committed to (once you stop it seems that for most the hair gained is lost).

For me the hair is important. I take Finasteride. I do a half dose a day (0.5 mg). The dose response curve of Finasteride gets flat pretty quickly (0.5 mg is 80-90% as effective as the full dose of 1 mg/day). Finasteride kinda has a maximum amount of DHT reduction it can do (tops out at about 70%).

It does have sexual side effects for some. Difficult to quantify what your risk is. Merck I think claims it’s 1-2%, anecdotes make me think it’s a little higher. I would guess it is in the ball park of 5%. I do think many of those with sexual sides likely had lower end T. I hypothesize that Finasteride just lowered overall androgens too much for these guys. I haven’t seen too many on T, get sides.

You could also look into saw palmetto. It will lower DHT, but IIRC, maybe not so much in the scalp? There are IIRC 3 types of 5 alpha reductase enzymes, and saw palmetto doesn’t impact the one in the scalp much? Could be off on this last statement.

There are other things out there too. Special shampoos, micro needling, RU58841 (which might be pretty good, but not many studies, and not approved for human use), hair transplant (but they will put you on Finasteride if you get one).

If you do decide to go the pharma route, you can try a low dose for awhile to see if it impacts you. Something like 0.5 mg EOD wouldn’t be too bad of a spot to start. Online services can be used to get Finasteride as well.

I think there is some fear mongering with Finasteride, but some of the people getting issues are legit. Do your research and do it extensively is my recommendation.

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This. I used it for years and it seemed to keep the thinning at bay. Even after I stopped using Propecia (Finasteride). Once I stopped the rogain, my hair just fell out quickly. I’m ok with it, I shave my head now.

Here is the long and the short of it. DHT is usually the culprit for reducing follicle size until they are gone for good. This only happens to people that are genetically predispositioned anyway. So… the TRT probably sped this up as you are not running TRT, you are running optimized T. You are over range. Your DHT is high compared to a normal dude. But… the point is you were likely going to lose it anyway.

Your choices… reduce T dose which you probably should anyway. This won’t likely do much. Start Rogain and commit to it. Start Rogain and Propecia. As @mnben87 stated it does have severe side effects for a small population.

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I think the genetics of this are not binary. It’s kinda a spectrum IMO. I don’t think I am very genetically prone to hair loss, but blasting and cruising has made it so that I think I am just a tad thinner on the crown. I had no perceivable hair loss at 30 and natty. Maybe if I stayed natty I wouldn’t have any until 40s or 50s instead of mid 30s. My hope with the Finasteride is to keep my hair in line with what it would be if I had stayed natty. My cruise DHT on Fin should be pretty similar to that of my low T natty DHT levels (probably a bit higher on the cruise / fin regimen).

I do think perhaps if using a DHT inhibitor (fin or dut) and Rogain (Minidoxidil), that growth from Rogain may stay after ceasing use? Just my hypothesis on that.

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So I guess one of my main questions to you gentlemen is are there any other options besides using even more medications that could possibly give me side effects and complicate my situation even more? Is there any way just for me to grow the hair that I have loss back?

A lot of guys on TRT are bald and yes I agree I am not pre disposed to hair loss but for some reason it’s happening to me. And I really do not want to be bald. I love my hair. But the last thing that I also want to do it out more medications into my body

Rogain, but it is a drug. I don’t think the side effects of it are much to worry about though. Some get lower BP on it (it was originally developed as a BP drug).

That saw palmetto might work. I haven’t researched it much TBH, so you would need to do the leg work there. That is an over the counter supplement (that doesn’t mean it doesn’t have sides though). It does seem to lower serum DHT, so with that, you may get sides from low DHT.

They have fibers you can put in your hair to make it appear thicker. Apparently if your hair isn’t too bad, these can work pretty well. Thickening conditioners exist. Not sure how much they do TBH.

Your most effective route is pharma though. Or hair transplant (and with that, they will likely try to get you on Fin).

If I stop TRT will my hair grow back?

Probably some, yes. It would be though lower DHT levels. Some guys grow hair using DHT inhibitors (Fin / Dut). Some just stop or slow down their loss.

I chose to stay on T and lower DHT to get the effect of being natty in regards to my hair.

IMO no. Honestly if we knew how to do that… we would be up there with the ranks of Bezos and Musk. Once the follicles have minaturized to the point of ceasing hair growth they are usually gone for good but not always. You could be one of the lucky few that gets some regrowth. I wouldn’t hold my breath.

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I agree here for the most part. Some get some regrowth. Emphasis on some. In this area, early detection and prevention work well, but it is mostly slowing down hair loss, not regrowth. Some lucky ones get regrowth.

If lots of hair is gone (to the point it’s noticeable), a hair transplant is the best option (unless you happen to be lucky and are a hyper responder to DHT inhibition and Rogain).

I guess if hair is important to a guy, there isn’t anything wrong with getting a transplant. It’s probably going to be 5-10K in the US, depending on how many follicles you desire.

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Topical finasteride has less risk and special shampoo can help, but other than what’s already been suggested, there isn’t much you can do about the hair loss.

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Ive noticed a great correlation between low shbg, high prolactin and diffuse thinning, like falling out all over the place, not the classical MPB.

The late Dr. Crisler noticed a connection between low SHBG and PFS.

I managed to keep my thinning hair from getting worse for a decade with Rogaine. I may have panicked but I stopped using Rogaine because I believed to be the cause of my ED a few years ago. That led me to TRT. I havent touched the stuff since and Im curious about keeping my thinning hair at times. Ive even considered what @mnben87 has suggested. Problem is I started to shave my beautiful head, and it’s been well received for over a year. I have a good looking head that actually looks better bald, and there are stupid reasons why women are attracted to men with hair and those with none. But what matters is, what are you willing to risk for a full head of hair? I’m not brave enough to get on Fin or Dut, but I am seriously considering it. I may tell my girl about it with the potential side effects as a side note. And see how she reacts. If she chooses hair. She’s out! Lol.


Whats PFS?

Post Finasteride Syndrome.


Agreed. Propecia is NOT worth it. Just my two cents.


So mine is not to the point to where the follicles have ceased growing hair. But the hair is starting to become super fine. So the notion line is I do not want to lose my hair. Some people are on this medication for running cycles and lifting weights or what ever the case maybe. Some people that run cycles they can run the cycle and then stop when they want. Me unfortunately I do not have that ability. I’m here because of health reasons and to be honest I just want to get off this medication and I would be willing to pay what ever I need too just get off of this I do not like doing this at all. I know if I stop I will go back to low T levels. The crazy thing is I don’t even know until this day of why my body started acting like this I wish I could really find out.

I have a question if I stop TRT and do hcg mono therapy would my DHT leaves still be increased and would I still lose my hair?? Or am I screwed no matter what as long as I’m taking testosterone?? Seems like if I do not take more meds or go get some type of hair procedure done then I’m basically going to lose all of my hair it what it seems like to me

HCG mono is not a permanent therapy. I assume you are talking about using it for an HPTA restart? Its not really for that solo either. Yes your DHT will drop when you cease the external Test.

Well if you stop no, but if you continue yes most likely.

Most likely.

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I agree with @blshaw. Just thought I’d add a few thoughts. Your DHT is going to be highly related to your Free T. Free T is what converts to DHT (and to E2). If you were to get to the same Free T level using HCG, or a SERM, you would very likely have the similar DHT levels to what you have now.

If you get off of Test, you will very likely have a significantly lower Free T level. So you will have a lower DHT level as well. Probably somewhere between a quarter and a half of what it is on T (depending on your natty levels and your TRT levels for Free T).

Here are my levels while using 875 mg of Test per week. I am still in range for DHT using 0.5 mg of Finasteride a day. I believe when I go back to my performance TRT / Cruise, that my DHT will be about what it was when I was natural (it was like 19 ng/dL). I also respond very well to adex. I was taking 0.25 mg EOD and pulled the blood work on the morning between my EOD adex and shots (didn’t take the Finasteride before the labs).

For cruise, I will have about my natty DHT, but much higher FT and TT. I’ll use a tiny bit of adex to keep DHT and E2 in similar proportions (they are generally about the same levels when I don’t take Adex or Fin). This is just a hypothesis I have, that androgens and E2 should kinda balance out. I want E2 to be a bit higher than just DHT, because I also will have a lot of T. I am a guinea pig lol.

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